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Anti-depressants 'of little use' Anti-depressants 'of little use'
(20 minutes later)
New generation anti-depressants have little clinical benefit for most patients, research suggests.New generation anti-depressants have little clinical benefit for most patients, research suggests.
The University of Hull team reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation. A University of Hull team concluded that the drugs helped only a small group of the most severely depressed.
They found the drugs helped only a small group of the most severely depressed, and in most cases had no more effect than taking a dummy pill. Marjorie Wallace, head of the mental health charity Sane, said that if these results were confirmed they could be "very disturbing".
The Royal College of Psychiatrists said the findings were "very important". But the makers of Prozac and Seroxat, two of the commonest anti-depressants, said they disagreed with the findings.
A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".
Reviewed data
And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".
In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.
They reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.
They focused on drugs in the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), which work by increasing levels of the mood controlling chemical serotonin in the brain.They focused on drugs in the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), which work by increasing levels of the mood controlling chemical serotonin in the brain.
These included fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat) - all commonly prescribed in the UK.These included fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat) - all commonly prescribed in the UK.
There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients Professor Irving KirschUniversity of HullThere seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients Professor Irving KirschUniversity of Hull
The number of prescriptions for anti-depressants hit a record high in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.The number of prescriptions for anti-depressants hit a record high in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.
The researchers found that even the positive effects seen on severely depressed patients were relatively small, and open to interpretation.The researchers found that even the positive effects seen on severely depressed patients were relatively small, and open to interpretation.
The seemingly good result came from the fact that these patients' response to the placebo decreased, rather than any notable increase in their response to anti-depressants. The seemingly good result came from the fact that these patients responded less to dummy pills (placebos) which they were given during trials, rather than any notable response to anti-depressants.
Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.
"This means that depressed people can improve without chemical treatments."This means that depressed people can improve without chemical treatments.
"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit.""Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."
'Small subset'
Professor Kirsch said the findings called into question the current system of reporting drug trials.Professor Kirsch said the findings called into question the current system of reporting drug trials.
Revieweing guidance
Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.
He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.
He called for drug companies to be forced to publish all their data.He called for drug companies to be forced to publish all their data.
The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.
A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available". Marjorie Wallace of Sane commented: "If these results were upheld in further studies, they would be very disturbing.
And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant". "The newer anti-depressants were the great hope for the future.... These findings could remove what has been seen as a vital choice for thousands in treating what can be a life-threatening condition."